Glenoid vault fixation

ABSTRACT

A joint prosthesis system, specifically a shoulder prosthesis, for shoulder replacement, revision and repair. The implants provide fixation into the best bone available to a surgeon. The implants are used in a superior-inferior and anterior-posterior construct forming a type of cross or X-shape. The implants allow for interchangeability of the articulating component as well as rotational orientation. The systems will allow for augments to accommodate bone loss. The implants may allow for additional security using screws or anchors inserted into the scapula.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of the following, which areincorporated herein by reference, in their entirety:

This application is a continuation-in-part of pending U.S. patentapplication Ser. No. 13/360,459 filed on Jan. 27, 2012, which carriesApplicants' docket no. CCF-1 and is entitled GLENOID VAULT FIXATION; and

Pending U.S. Provisional Patent Application No. 61/568,530 filed Dec. 8,2011, which carries Applicants' docket no. CCF-1 PROV, and is entitledGLENOID VAULT FIXATION.

BACKGROUND

The present disclosure relates to shoulder repair and revision surgery.More accurately, the present disclosure relates to a shoulder prostheticand more precisely to a glenoid or glenosphere vault system forrepairing or revising a shoulder. It is contemplated that this system isapplicable to shoulder and reverse shoulder repair. It is contemplatedthat the systems and methods set forth herein, or any adaptations, maybe useful outside of and beyond shoulder repair and humerus repair.

One attribute of shoulder repair surgery is the limit of anatomical bonethe patient has to provide for adequate repair and even more so withshoulder revision. The shoulder naturally only provides a limited amountof bone for the shoulder joint to function. When shoulder repair isneeded it is often performed with large anchor devices embedded in whatbone is available to allow for proper security of an articulatingsurface or glenosphere to attach to the anchor. These devices require alarge removal of bone. Further revision surgery requires even greaterbone loss as original anchors are removed and replaced with new anchors.There is a need to have a smaller footprint anchor without limiting thefixation of the articulating components. There is also a need to havethe ability for revision shoulder repair without removal of the originalanchors, solely replacing the articulating components.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the present system will now be discussed withreference to the appended drawings. It is appreciated that thesedrawings depict only typical examples of the present system and aretherefore not to be considered limiting of the scope of the invention,as set forth in the appended claims.

FIG. 1A is an exploded perspective view of a glenoid vault system with asuperior-inferior (SI) component, an anterior-posterior (AP) component,an articulating component and screws;

FIG. 1B is an exploded bottom perspective view of a glenoid vault systemwith a superior-inferior (SI) component, an anterior-posterior (AP)component, an articulating component and screws;

FIG. 2 is an assembled perspective view of the glenoid vault system ofFIG. 1;

FIG. 3 is a cross sectional side view of the glenoid vault system ofFIG. 1;

FIG. 4 is an exploded perspective view of the SI and AP components ofFIG. 1;

FIG. 5 is a cross-sectional side view of the assembled SI and APcomponents of FIG. 1;

FIG. 6 is a perspective top view of the SI and AP components of FIG. 1;

FIG. 7 is a top view of the SI and AP components of FIG. 1 with the APcomponent rotated to show it is rotatable about the center of the SIcomponent;

FIG. 8 is a perspective view of the SI component of FIG. 1;

FIG. 9 is a cross-sectional side view of the SI component of FIG. 1;

FIG. 10 is a perspective view of the AP component of FIG. 1;

FIG. 11 is a side view of the AP component of FIG. 1;

FIG. 12 is a cross-sectional side view of the AP component of FIG. 1;

FIG. 13A is a partially exploded perspective view of the SI and APcomponents of FIG. 1 and a glenosphere;

FIG. 13B is a bottom partially exploded perspective view of aglenosphere and a metaglene;

FIG. 13C is a top perspective exploded view of the glenosphere and ametaglene;

FIG. 13D is a bottom perspective, assembled view of the glenosphere ofFIG. 13A;

FIG. 14A is a perspective view of the glenosphere of FIG. 13D engagedwith an actuating instrument with a handle, rod and threaded portion;

FIG. 14B is a cross section of the glenosphere of FIG. 13D engaged withthe actuating instrument of FIG. 14A;

FIG. 15A is an exploded perspective view of a glenoid vault system withan SI component, an AP component with an augment, an articulatingcomponent and screws;

FIG. 15B is an exploded bottom view of a glenoid vault system with an SIcomponent, and AP component with an augment, an articulating componentand screws;

FIG. 15C is a side view of a glenoid vault system with an SI component,an AP component with an augment, an articulating component and screws;

FIG. 16 is an assembled perspective view of the glenoid vault system ofFIG. 15;

FIG. 17 is a perspective view of the AP component of FIG. 15;

FIG. 18 is a perspective view of an assembled SI component of FIG. 1 or15 and a cylindrical component;

FIG. 19 is a perspective view of the cylindrical component of FIG. 18;

FIG. 20 is a partially exploded perspective view of the SI component ofFIG. 1 or 15, the cylindrical component of FIG. 18 and an articulatingcomponent with augment;

FIG. 21 is an assembled side view the SI component of FIG. 1 or 15, thecylindrical component of FIG. 18 and the articulating component withaugment of FIG. 20;

FIG. 22 is a bottom perspective view of the articulating component withaugment of FIG. 20;

FIG. 23 is a bottom perspective view of an articulating component withstepped augment;

FIG. 24 is a partially exploded alternate embodiment of a glenoid vaultsystem with a horizontal member, vertical member, screws, a hexcomponent and an articulating component;

FIG. 25 is a cross sectional side view of the glenoid vault system ofFIG. 24 with the horizontal member extending across the page;

FIG. 26 is a perspective view of the vertical and horizontal members ofFIG. 24;

FIG. 27 is an exploded perspective view of the vertical and horizontalcomponents of FIG. 24;

FIG. 28 is a perspective view of the vertical component of FIG. 24;

FIG. 29 is a top view of the vertical component of FIG. 24;

FIG. 30 is a perspective view of the horizontal component of FIG. 24;

FIG. 31 is a top view of the horizontal component of FIG. 24;

FIG. 32 is a cross sectional side view of the horizontal component ofFIG. 24;

FIG. 33 is a perspective view of the vertical component of FIG. 24 and acylindrical member;

FIG. 34 is a perspective view of the vertical and horizontal componentof FIG. 25 with an augment member;

FIG. 35 is a perspective view of the augment member of FIG. 34;

FIG. 36 is a side view of the glenoid vault system of FIG. 24 with theaugment of FIG. 35;

FIG. 37 is a perspective view of an alternate augment;

FIG. 38 is a side view of the glenoid vault system of FIG. 24 with theaugment of FIG. 37;

FIG. 39 is a perspective view of an alternate augment;

FIG. 40 is a side view of the glenoid vault system of FIG. 24 with theaugment of FIG. 39;

FIG. 41 is a perspective view of an alternate embodiment of an anchoringsystem for the glenoid vault with an alternate vertical member andhorizontal member and screws;

FIG. 42 is a top view of the alternate embodiment anchoring system ofFIG. 41 with the vertical component rotated to show it is rotatableabout the center of the horizontal component;

FIG. 43 is a perspective view of the anchoring system of FIG. 41 withthe vertical member slightly exploded from the horizontal member;

FIG. 44 is a perspective view of the horizontal member of FIG. 41;

FIG. 45 is a perspective view of the vertical member of FIG. 41;

FIG. 46 is a perspective view of an alternate embodiment of an anchoringsystem for the glenoid vault with blade anchors;

FIG. 47 is a top view of the anchoring system of FIG. 46;

FIG. 48 is a perspective view of the horizontal member of FIG. 46;

FIG. 49 is a perspective view of the vertical member of FIG. 46;

FIG. 50 is a perspective view of a sample blade anchor for use in thesystems of FIGS. 46, 52 and 54;

FIG. 51 is a perspective view of an alternate embodiment of an anchorwith bone wall filler;

FIG. 52 is a perspective view of a one piece vertical member with builtin anchors and slots to receive more anchors;

FIG. 53 is a top perspective view of the one piece vertical member ofFIG. 50 with horizontal anchors in the slots;

FIG. 54 is a perspective view of an alternate embodiment glenoid vaultsystem with a vault, screw, anchors and glenoid;

FIG. 55 is an exploded perspective view of the system of FIG. 54;

FIG. 56 is a cross sectional view of the vault and screw of FIG. 54;

FIG. 57 is a bottom perspective view of the glenoid of the system ofFIG. 54; and

FIG. 58 is a bottom perspective view of a glenosphere that may beattached to the vault system of FIG. 54 in place of the glenoid.

DETAILED DESCRIPTION

The present disclosure provides systems, apparatus, and methods forshoulder replacement, repair and revision. The systems and methodsdescribed herein may improve shoulder prosthetics for use in shoulderarthoplasty and revision surgeries and provide stronger attachment ofprosthetics to bone.

In this specification, standard medical directional terms are employedwith their ordinary and customary meanings. Superior means toward thehead. Inferior means away from the head. Anterior means toward thefront. Posterior means toward the back. Medial means toward the midline,or plane of bilateral symmetry, of the body. Lateral means away from themidline of the body. Proximal means toward the trunk of the body. Distalmeans away from the trunk.

In this specification, standard shoulder anatomical terms are employedwith their ordinary and customary meanings.

Referring to FIG. 1A, a perspective view illustrates a glenoid vaultsystem 10 that may be implanted into a shoulder. The glenoid vaultsystem 10 includes an articulating component 20, which may also bereferred to as a glenoid, anchoring components which include asuperior-inferior (SI) or vertical component 100, an anterior-posterior(AP) or horizontal component 200 and anchors 300 which may be screws.The system 10 creates interaction the different components with thearticulating component 20 engaging the AP component 200 and the APcomponent engaging the SI component 100. The screws 300 may pass throughdifferent portions of the AP component 200 and the SI component 100.

The articulating component 20 may include a body 21, an articulatingsurface 22 and a bone-facing surface 26. The body 21 may be shaped tominor an anatomical shoulder. The articulating surface 22, which mayalso be referred to as a first surface, may be smooth or rough on amicro- or macroscopic level. The articulating surface 22 may besemi-spherical or concave, and may be peripherally surrounded by a wall24, which may also be referred to as a side portion. The wall 24 mayextend between the articulating surface 22 and the bone-facing surface26, where the bone-facing surface 26 is opposite to the articulatingsurface 22. When inserted, the bone-facing surface 26 may rest againstthe shoulder bone.

Referring to FIG. 1B, the bone-facing surface 26, which may also bereferred to as a second surface, may include a post 28 extending outwardfrom the bone-facing surface 26. The post 28 may be integral to thebone-facing surface 26, or may be separately formed from the body 21.The post 28 may extend substantially perpendicular to the articulatingsurface, and may be oriented such that it extends from a substantiallycentral location of the bone-facing surface.

The post 28 may be substantially cylindrical and include a proximalshoulder portion 29, which may contact the bone-facing surface 26. Theshoulder portion may include a plurality of notches 32, which may alsobe referred to as keels, teeth, blades, or leafs that extend along thelength of the shoulder portion 29, and may be situated around the entirecircumference of the post 28.

The post 28 may also include a circumferential groove or channel 30,which may also be referred to as a ring shaped cutout. Thecircumferential groove 30 may be located distal to the shoulder portion29, and may extend continuously around the entire circumference of thepost 28.

Referring to FIGS. 2 and 3, the glenoid vault system 10 assembles withthe SI component 100 being embedded in the bone (not shown). The APcomponent 200 may rotate about a portion of the SI component with atleast a portion of the AP component 200 within the SI component 100before the AP component 200 is secured to the bone.

The articulating component 20 may be lockably attached to the APcomponent 200 by inserting the post 28 into a portion of the APcomponent 200, and may be secured to the AP component 200 via acomplementary fit of the circumferential groove 30 with a complementaryfeature on the AP component 200. The articulating component 20 mayotherwise be secured to the AP component 200 by another locking means,such as a Morse taper (not shown).

The system is described in further detail herein.

Referring to FIGS. 4-7, the SI component 100 and AP component 200interact through a body 102, which may be a central ring, of the SIcomponent 100 and a tubular boss 202 of the AP component 200. Thetubular boss 202 may also be referred to as a protruded portion. Thebody 102 may be a ring and the ring may be central to the SI component100; however, the geometric component may be offset from the center aswell and may be any shape including cylindrical or other polygonalshape. The tubular boss 202 extends distally from a cylindrical wall 204defining a hole 206, wherein the hole may be a centralized or a centralhole. The tubular boss 202 may slidably engage the central ring 102allowing the AP component 200 to rotate about the central ring 102 ofthe SI component 100. The AP component 200 may be secured to the SIcomponent 100 through a Morse taper. The SI and AP components 100, 200form a cruciate when they are engaged. A cruciate means a cross shape orX shape.

Referring to FIG. 8, the SI component 100 may include a bore 103, whichmay be a central bore, extending at least partially through the body orcentral ring 102 in a longitudinal direction and may extend entirelythrough the central ring 102. The SI component includes a distal end 104and may include two arms 106, 108 extending from the central ring 102.The arms 106,108 may be integral to the body 102, or may be separatelyformed. The arms 106, 108 include a proximal end 110 and a distal end112 that is the same distal end 112, 104 of the SI component 100.Portions of the arms 106, 108 extend proximally from the central ring102 giving the SI component 100 a V or U-shaped configuration for the SIcomponent 100. The extension of the arms 106 proximally may besubstantially parallel and substantially the same length, wherein thearms are coplanar; however the arms may differ in length slightly aswell which may give the SI component 100 a J-shape, wherein the arms arenot coplanar. The extension of the arms 106, 108 may be collinear andthe arms 106, 108 may prove to be minor images if a cross section istaken of the SI component 100. The portion of the arms 106, 108 towardthe central ring 102 may cylindrically curve around the central ring 102with the same degree of curvature as the central ring 102. The body ofthe SI component 100 may be longer than it is wide from a top viewproviding a narrow footprint when the SI component sits within the bonewith the arms 106, 108 narrower than the central ring 102.

The arm 106 may include an opening or bore 114 defined by a wall 116,which may be an arm ring, which may be cylindrical in shape, at the endof the arm 106. Bores 114 may also be referred to as lateral passages.The arm ring 116 may protrude from the arm 106 in substantially the samedirection as the arm 106 extending from the central ring 102. Theopening 114 may extend entirely through the arm ring 116 substantiallyparallel with the central bore 103. The opening 114 is substantiallycircular in cross section and configured to receive a screw 300. Theopening 114 may include recesses, conical in shape, to guide the screw300 into place in the SI component 100 as well as seat the screw 300 inits proper place. The opening 114 may be a double conical shape with thenarrowest point seated toward the middle of the opening 114, the shapeexpanding outward toward either end of opening 114, as best seen in FIG.9. The opening 114 may slidably or threadably receive the screws 300.The recesses in the openings 114 may allow for the heads of the screws300 to sit flush with a proximal surface 120 at the proximal end 110 ofthe arms 106, 108 of the SI component 100. The arm 108 may includesimilar or identical features as arm 106, but extending in the oppositedirection from the central ring 102.

The SI component 100 may be made from numerous different materials thatinclude, but should not be limited to, titanium and alloys,cobalt-chrome and alloys, stainless steel, ceramic, tantalum, PEEK,PEAK, hydroxyapatite and biocompatible materials.

Referring to FIG. 9, the central ring 102 includes a larger cylindricalreceiver 122 for receiving the tubular boss 202 of the AP component 200.The central ring 102 also includes a central opening 118 distal thecylindrical receiver 122. The central opening 118 may be conical inshape with the wider portion of the central opening toward the distalend 104. The proximal portion of the central opening 118 may include aseat 119, shaped to receive the head of a screw. One screw 300 may passthrough the central bore 103, and the head of the screw may be capturedon the seat 119, engaging the SI component 100 and locking it to thebone. The screw 300 may threadably or slidably engage the central bore103.

A bone, wherein the bone may be a scapula, may be properly prepared byplacing a guidewire on the bone. The bone is then reamed and a primaryhole is drilled, the primary hole is drilled at size to allow thecentral ring 102 of the SI component 100 to fit within the primary hole.Secondary holes or pilot are drilled, sized, and shaped to accept otherportions of the SI component. A cutting or punch instrument may be usedto connect or bridge the primary and secondary holes. The bone is thenbroached for the near net shape of the SI component 100. An SI broachmay be used as a trial implant. With the broach in the bone, or vault ofthe bone, the AP holes may be drilled to fit the exact size of the APcomponent 200. The same steps for the preparation of the SI component100 are mimicked for the AP component 200 while the SI trial is in thebone, or vault of the bone. After proper size, shape and orientation aredetermined, the AP and SI trials are removed and replaced with theactual SI and AP components 100, 200, that can be secured to the boneusing proper screws 300 or other anchors. The screws 300 may through thecentral bore 103 and the head of the screw 300 engages the SI component100 through the conical shaped opening, securing the SI component to thebone. Additional screws may pass through the openings 114 for greatersecurity of the SI component 100 to the bone. The AP component 200 maybe further secured as well with screws that pass through holes 214 ofthe AP component 200

Referring to FIGS. 10 and 11, the AP component 200 may include thecentral cylindrical wall 204 defining the central hole 206 extendingentirely through the AP component with the central hole 206 passing intothe tubular boss 202. The central hole 206 and tubular boss 202 mayinclude a central axis 205 that extends through the center of the hole206. The tubular boss 202 may be an extension of the central hole 206.The tubular boss 202 may be circumferentially smaller than thecylindrical wall 204 defining the central hole 206.

The central hole 206, which may also be referred to as a first aperture,may be shaped to receive the post 28 of the articulating component 20. Aproximal portion 207 of the central hole 206 may include a plurality ofvertical grooves or channels 209 that are complimentary to the notches32 on the shoulder portion 29 of the post 28. The grooves 209 may allowfor rotational orientation of the articulating component 20 and may becross-sectionally rounded or squared. Further, the central hole 206 mayinclude a circumferential engagement ring 222, as illustrated in FIG.12, that is distal to the plurality of grooves or channels 209, andproximal to the tubular boss 202. The engagement ring may have acomplementary shape to the circumferential groove 30 on the post, andmay protrude out from the central wall 204, extend toward the center ofthe central hole 206, or it may be a cut out within the central wall204, extending away from the center of the central hole 206.

An alternate embodiment of an anti-rotation/rotational orientationfeature which may take the place of the notches or grooves 209 mayinclude splines (not shown) extending from a proximal surface 224 ofeither the AP or SI component 100, 200. The splines may engage crescentbosses (not shown) that extend from the bone facing surface 26 of thearticulating component 20. The crescent bosses may include multipleholes for receiving the splines.

First and second AP arms 208, 210 extend away from the central hole ator toward the proximal end 206 of the AP component 200. The AP arms 208,210 may be collinear with the first AP arm 208 extending in an oppositedirection as the second AP arm 210. Each of the AP arms 208, 210 may bethe same length; however, the AP arms 208, 210 may differ in length aswell depending on the patient anatomy and what bone is available tosecure the AP component 200 to. Similar to the SI component arms 106,108 the AP arms 208, 210 each have arm walls 212, which may be AP armrings. The AP arm rings 212 may protrude from the arms 208, 210 insubstantially the same direction as the arms 208, 210 extending from thecylindrical wall 204. The AP arm rings 212 include holes 214 extendingentirely through the AP arm rings. The holes 214 may also be referred toas AP lateral passages. The holes 214 may be substantially cylindricalin shape, to allow for passage of the screws 300 to aid in securing theAP component 200 to the bone.

One or more keels 216 may extend distally from the AP arms toward adistal end 218 of the tubular boss 202. The keels 216 may be used forbone purchase. The keels 216 may extend beyond the distal end 218 of thetubular boss. keels 216 may cylindrically curve around the tubular boss202 with the same degree of curvature as the tubular boss 202. The keels216 may extend substantially parallel to one another creating a slot 220between each one of the keels 216 and the tubular boss 202. The slot 220receives the central ring 102 of the SI component 100. The keels 216 mayprovide rotational stops when the keels engage the arms 106, 108 of theSI component 100 preventing any further rotations of the AP component200. The body of the AP component 200 may be longer than it is wideproviding a narrow footprint when the AP component 200 engages the SIcomponent 100 and resides in the bone.

To engage the articulating component 20 with the AP component 200, thepost 28 on the bone-facing surface 26 of the articulating component 20may be at least partially inserted into the central hole 206 of the APcomponent 200, until the circumferential groove 30 on the post engageswith the engagement ring 222 in the central hole 206. Once the post 28has been inserted into the central hole 206, the complementary fit ofthe engagement ring 222 with the circumferential groove 30 serves toreversibly lock axial movement of the articulating component 20 withrespect to the AP component 200. The interaction of the engagement ring222 with the circumferential groove 30 may be a snap fit or a seal oranother locking mechanism. Further, the plurality of grooves 209 on thecentral hole 206 may capture the proximal notches, which may restrictaxial rotation about the central axis 205 of the central hole 206.

The holes 214 in the arms 208, 210 may taper or recess from the proximalend 207 toward a distal end providing guidance for the screws andengagement with the screw heads. The holes 214 may threadably orslidably receive the screws 300 and the recesses or tapers may allow thescrew head to sit flush with a proximal surface 224 at the proximal end207 of the AP component 200.

The AP component 200 may be made from numerous different materials,which include, but should not be limited to, titanium and alloys,cobalt-chrome and alloys, stainless steel, ceramic, tantalum,hydroxyapatite and biocompatible materials.

One method of implanting the system 10 includes preparing the bone aspreviously described and implanting the SI component 100 into the bonewith appropriate screws 300. The AP component 200 may properly engagethe SI component 100 with the tubular boss 202 slidably engaging thecentral ring 102, wherein a central axis of the tubular boss 205 may beaxially aligned with a central axis of the central ring. 02. The APcomponent 200 is carefully placed at a proper angle, which may bepredetermined, within the best available bone to provide greatersecurity. Screws 300 may pass through the holes 214 to secure the APcomponent 200 to the bone. The articulating component 20 may engage theAP component 200 after it the AP component 200 is properly placed andpositioned within the SI component 100 and the bone. The order in whichthe components engage one another is not restrictive and separate ordermay be established such as engaging the SI and AP component 100, 200prior to implanting into the bone.

Referring to FIGS. 13A-13B, a glenosphere 60 may replace or be usedinstead of an articulating component 20. The glenosphere 60 may be usedfor a reverse shoulder arthroplasty but may engage the AP component 200in the same manner as the articulating component 20 Referring to FIG.13A, a glenosphere 60 is shown in relation to an AP-SI complex, whereina post extending from a distal portion of the glenosphere is shaped tobe received in the central hole 206 of the AP component.

The glenosphere 60 may include a body 61, an articulating surface 62 anda distal surface, bone-facing surface 64. The articulating surface 62may be substantially semi-spherical or domed shape and may be smooth orrough on a micro- or macro scale. The articulating surface may alsoinclude an aperture 65 at or near the apex of the dome 62. The radius ofcurvature of the domed articulating surface 62 may vary to accommodatevarious patient anatomies.

Referring to FIG. 13B, the bone facing surface 64 is substantiallycircular, and intersects the dome-shaped articulating surface at allpoints along its circumference. The bone facing surface 64 may alsoinclude a substantially circular recessed portion 68 or dome cutout,which may be offset from the center of the bone facing surface 64. Therecessed portion 68 may otherwise be oval or polygonally shaped. Therecessed portion 68 may be shaped to receive a metaglene component 66.The recessed portion 68 may be defined by a circumferential wall 61 andinclude a ceiling surface 63. The aperture 65 may extend entirely fromthe articulating surface 62 to intersect the ceiling surface 63 of therecessed portion.

Referring to FIG. 13C, the aperture 65 may include a threaded portion 67to engage a threaded instrument that may be used for insertion orremoval of the glenosphere from an AP-SI complex that has been insertedinto the bone as described above.

As illustrated in FIGS. 13B and 13C, the metaglene component 66 may beformed separately from the glenosphere 60, and may be substantiallydisc-shaped or stoutly cylindrical. Alternatively, the metaglenecomponent 66 may be integrally formed with the body 61 of theglenosphere 66. The metaglene component 66 may otherwise by oval orpolygonally shaped. Metaglene component 66 may include a body 67, afirst, glenosphere-facing surface 69 and a distal surface 71.

The distal surface 71 of metaglene component 66 may include a post 72that extends substantially perpendicularly away from the distal surface71, which may include features similar to post 28 on the articulatingcomponent 20 described previously, such as a shoulder portion 29 with aplurality of notches 32, and a circumferential groove 76 shaped tolockably engage a complementary engagement ring 222 in the central holeof the AP-component. Additionally, the post 72 may include a step 74that extends between the shoulder portion 29 and the distal surface 71.Alternatively as illustrated in FIG. 13D, the shoulder portion may besmooth, and include no engagement features such as notches, to allow themetaglene to rotate axially with respect to the central axis 205 of thecentral hole 206 of the AP-component 200.

The metaglene may also include at least one metaglene hole 70 thatpasses entirely through the body, and may be shaped to receive screws tofixate the metaglene to the bone. The metaglene holes 70 may alsoprovide a place for securing an augment to the glenosphere.

As best seen in FIG. 13D, the metaglene 66 is shaped to be received bythe recessed portion 68, and may engage the recessed portion 68 througha Morse-taper. The metaglene 66 may also be attached to the glenospherevia a press or snap fit. After the metaglene 66 is inserted into therecessed portion 68 of the glenosphere 60, the distal surface of themetaglene component 66 may sit flush with the bone facing surface 64 ofthe glenosphere 60.

Referring to FIGS. 14A and 14B, the glenosphere 60 is shown engaged withan actuating instrument 80, which includes a threaded distal portion 82,and elongated intermediate portion 84, which may be rod-shaped and aproximal handle portion 86. The handle 86 may extend substantiallyperpendicular to the rod 84. The instrument 80 engages with the threads67 of the aperture 65 located at the apex of the domed articulatingsurface 62.

To secure the glenosphere to the AP component, the post 72 may bepartially inserted into the central hole 206 of the AP component. Theinstrument 80 may then be used to advance the glenosphere 60 andattached metaglene 66 component distally until the circumferentialgroove 30 engages the engagement ring 222 and a the glenosphere 60becomes reversibly locked to the AP component 200. The instrument 80 mayact to advance the glenosphere 60 and metaglene 66 construct by engagingthe distal threaded portion 82 with the threaded portion 67 of theaperture 65 and turning the handle 86 in a first direction.

The instrument 80 may also be used to separate a glenosphere-metagleneconstruct that has been inserted into an AP-component 200, for example,to replace the glenosphere 60 with an articulating component 20. Thethreaded distal portion 82 of the instrument 80 may engage the threadedportion 67 of the aperture 65, and the handle 86 may be turned in asecond direction that is opposite of the first direction. As the handle86 is turned in the second direction, an upward force is applied againstthe threads 67 in the aperture, thus creating a separating force on theglenosphere-metaglene construct. The upward force may be great enough toovercome the snap fit lock of the engagement ring 222 with thecircumferential groove 30 on the post 78, and the glenosphere may begently removed from the AP component.

Alternatively, the actuating instrument 80 may be used to remove onlythe glenosphere component, leaving the metaglene component to beaccessed by the surgeon for further removal. The threaded portion 82 ofthe actuating instrument 80 may engage the threaded portion 67 of theaperture such that as the handle 86 is turned in a first direction, theinstrument 80 moves distally in the aperture 65 until it contacts theglenosphere-facing surface 69 of the metaglene 66. As the handle turns86 in the first direction, a sufficient force is applied against theglenosphere-facing surface 69 of the metaglene to “pop off” the domedglenosphere component 60, overcoming the Morse-taper fit and releasingthe glenosphere component, leaving only the metaglene 66 componentattached to the AP component 200. The metaglene 66 can then also beremoved by pulling upwards to release the engagement ring 222 from thecircumferential groove 30, thus releasing the post 28 from the centralhole 206.

It can be best seen in FIG. 14B that the recessed portion 68 and theattached metaglene 66 are offset from the center of the distal face 64.The offset may better allow a surgeon the ability to “dial” themetaglene 66 to the necessary anatomic position for the glenosphere 60.This is of particular importance in reverse total shoulder arthroplasty,where a glenoid may be inserted in a position that is not sufficientlyanatomically inferior. Upon revision (removal of the glenoid andreplacement with a glenosphere), scapular notching may occur, causingmuch pain and further shoulder degradation to the patient. Bymodularizing the metaglene component 66 and offsetting the placement ofthe metaglene 66 within the glenosphere 60, a surgeon may be able to“lateralize” the joint by moving the glenosphere further away from theoriginal joint line.

The glenosphere 60 and the articulating component 20 may engage the APcomponent 200 without removal of either the AP component 200 or the SIcomponent 100 of the glenoid vault system 10. Revision surgery is donewith greater ease because the components can be snapped in and out ofthe SI and AP anchors 100, 200 without removal of any more bone.

Referring to FIGS. 15A-15C, an alternate embodiment of a glenoid vaultsystem 410 includes an articulating member 420, an AP component 500 withan augment, the SI component 100 and the anchors or screws 300. Theinteraction between the different components is similar to the previousembodiment.

The articulating member 420 is substantially similar to the previouslydescribed embodiment of an articulating component 20. The articulatingmember 420 has a curvature shaped to mirror an anatomical shoulder witha semi-spherical or concave articulating surface 422 peripherallysurrounded by a wall 424. The articulating component also includes abone-facing surface 426 facing the opposite direction as thearticulating surface 422 and a post 428 extending from the bone-facingsurface 426 in a substantially central location of the bone-facingsurface 426. The bone facing surface 426 may rest against the scapula.The post 428 may include a ring shaped cutout 430 toward the distal endof the post 428 and notches 432 toward the proximal end of the post 428.However, this embodiment of the articulating member 420 includes anaugment 434 extending from the bone facing surface 426 separate from thepost 428 and the augment 434 is not as long as the post 428. It will beappreciated that in some instances or embodiments the augment 434 mayextend or be longer than, or the same length as, the post 428.

Illustrated in FIG. 15B, the augment 434 may extend from only one sideof the bone-facing surface 426. The augment 434 includes a surfaceportion 435 that extends along a transverse plane that is substantiallyparallel with a horizontal axis 433 that extends through theintersection of the distal post 428 with the bone-facing surface 426, asillustrated in FIG. 15C. The surface portion 435 may be wing shaped andextend radially from the center of the bone-facing surface 426. Theshape of the augment surface may vary. The augment may be peripherallydefined by a perimeter wall 437 that extends perpendicular to thetransverse plane 433. The height of the perimeter wall 437 may varyalong the periphery of the augment to match the contoured bone facingsurface 426 of the articulating member 420. The curvature of a portionof the peripheral wall may follow the peripheral curvature of the wall424 of the articulating member 420. Another portion of the peripheralwall may extend straight across the length of the bone-facing surface426.

The surface area of the augment 434 may be less than half of the totalsurface area of the bone-facing surface 426. Referring to FIG. 16, theaugmented articulating member 420 is shown engaged with an augmented APmember 500. The augment 434 interacts with a portion of the AP component500 that will be discussed further herein. The augment 434 is providedto replace an area where much of the bone has been removed.

Referring to FIG. 17, the AP component 500 may include the centralcylindrical wall 504 defining central hole 506 extending entirelythrough the AP component with the central hole 506 passing into thetubular boss 502. The tube of the tubular boss 502 may be an extensionof the central hole 506. The tubular boss 502 may be circumferentiallysmaller than the cylindrical wall 504 defining the central hole 506while the circumference of the central hole 506 may remain constantthrough from the cylindrical wall 504 to a distal end 510 of the tubularboss 502. At a proximal end 512 the central hole 506 of the AP component500 may reside notches or grooves 509 that may serve a complimentary fitwith the notches 432 of the articulating component 420 to allowrotational orientation of the articulating component and preventrotation of the articulating component 420 after engaging the APcomponent 500. The engagement of the post 428 with the central hole 506may occur similar to the engagement of post 28 with central hole 206 asdescribed previously.

An AP augment 508 extends away from the central hole 506 from the distalend 510 of the AP component 500 and may be shaped to receive the augment434 of the articulating member 420. The AP augment 508 may extend 180°or more around the circumferential edge of the cylindrical wall 504. Aperipheral wall 514 wraps around the AP augment 508 and may match thecurvature of the articulating member 420. The AP augment 508 alsoinclude an articulating facing side 516 and a bone facing side 518. Thearticulating facing side 516 may include pockets 520 divided by a ridge522. The pockets 520 receive and complimentary fit the augment 434 ofthe articulating member 420. The pockets 520 may match the curvature ofthe peripheral wall 514 of the AP augment 508. Each pocket 520 mayinclude an augment hole 524 to allow for passage of a screw. The augmenthole 524 may pass through the entire body of the AP augment 508 insubstantially the same direction as the central hole 506. The screw maythreadably or slidably pass through the augment hole 524 wherein thescrew head may engage the augment hole 524 and secure the AP component500 to the bone.

The AP component 500 may include the same or similar features as thepreviously described embodiment including the engagement ring 222 thatengages the ring shaped cutout 430 of the articulating member 420. TheAP component 500 also includes the grooves or notches 509 that interactwith the notches 432 of the articulating member 420 in much the samemanner as the previous embodiment to allow rotational orientation of thearticulating component and prevent rotation of the articulating member420 about the AP component 500.

A method of implanting this embodiment of the glenoid vault system 410is similar to that previously described herein substituting thealternate embodiment AP component 500 for the previous AP component 200.

Referring to FIGS. 18 and 19, a cylindrical component 600 may includesome of the similar features of the previous AP components 200, 500. Thecylindrical component 600 includes the same or similar features as thepreviously disclosed AP components 200, 500 with the exclusion of armsand augments and simply includes the cylindrical portion itself.Cylindrical component 600 includes a tubular boss 602 extending from acylindrical wall 604 defining a central hole 606. The tubular boss 602may be circumferentially smaller than the cylindrical wall 604 definingthe central hole 606 while the circumference of the central hole 506 mayremain constant through from a proximal end 608 of the cylindrical wall604 to a distal end 610 of the tubular boss 602. Similar to the previousembodiments, at the proximal end 608 of the cylindrical wall 604 residenotches or grooves 612 which may serve as a complimentary fit with thenotches of the articulating members or components, or the glenosphere toallow rotational orientation of the articulating component and preventrotation of the articulating member or component, or glenosphere afterengaging the AP component 600.

The cylindrical component 600 may also include the engagement ring 222as previously disclosed for securing an articulating component or memberor glenosphere, particularly the post portion of the articulatingcomponent, to the cylindrical component 600. The security of the twoparts may come from a seal or snap fit, or other locking means includinga Morse taper (not shown) which may not require an engagement ring, aspreviously described herein.

The cylindrical component 600 may be advantageously suited for use withan augmented articulating component or augmented glenosphere in that noarms, like those found in the other AP components 200, 500, are in theway of the augments on the articulating component and glenospheredesigns.

Referring to FIGS. 20-22, an articulating component 720 includes anaugment 722 as part of the articulating component, essentially aone-piece articulating component with augment. A peripheral wall 724extends from an articulating surface 730 to the bone-facing surface 726.The augment 722 may be separate from a post 728 and extend from a bonefacing side 726 separate from where the post 728 extends from the bonefacing side 726. The articulating component 720 further includes notches732 that interact or engage the grooves or notches 612 of thecylindrical component in much the same manner as the previous embodimentforming a complimentary fit preventing rotation of the articulatingcomponent 720. The post 728 may further include the ring shaped cutout734 for locking the articulating component 720 to the cylindricalcomponent 600.

The augment 722 may also be rounded or smoothly tapered extending fromthe peripheral wall 724. The augment 722 may extend from the peripheralwall 724 toward a medial line or middle point of the articulatingcomponent 720 and wrap around the post 728 but not contacting the post728. The post 728 may be greater in length than the augment 722. Theaugment 722 of the articulating component 720 is to replace that area ofthe shoulder where bone may be removed, as is the case with all theaugment designs disclosed herein.

Referring to FIG. 23, an alternate embodiment of an articulatingcomponent 760 may include an augment 762 with a step-down taper. Thestep-downs may step down both peripherally and in a lateral directionfrom a middle point or medial line of the articulating component 760.The remainder of the alternate embodiment may be substantially similaras the previous articulating component 720 embodiment.

Referring to FIGS. 24 and 25, there is depicted an alternate embodimentof a glenoid vault system 1000. The components in this embodiment aresimilar to the previous system 10. An articulating component 1020 issubstantially similar to the previous articulating component 20; howeverthe articulating component 1020 does not include notches to preventrotation of the articulating component 1020. In this embodiment apolygon, or keyed, component 1060 that includes a cylindrical hole 1062,is inserted onto or wraps around a post 1022, which may be cylindricalin shape, of the articulating component 1020. The polygon component 1060may be press fit onto the post. The polygon component 1060 may behexagonal in shape. The polygon component 1060 engages a complimentaryrecess within an AP component 1200, preventing rotation of thearticulating component 1020.

The post 1022 includes substantially the same feature of a cutoutconfigured to interact with an engagement ring on the AP component 1200to lock the post 1022 to the AP component 1200. The lock may be a snapfit, or seal 1024, or other locking means including a Morse taper (notshown) which may not require an engagement ring.

Referring to FIGS. 26 and 27, the glenoid vault system 1000 alsoincludes an SI component 1100 and AP component 1200 and anchors orscrews 1300 similar to the previous system 10. The features of thesecomponents differ slightly and will be described further herein. Theinteraction between the SI component 1100 and AP component 1200 issubstantially the same as the previous system 10. A tubular boss 1202 ofthe AP component may slideably engage a central ring 1102 of the SIcomponent, allowing the AP component to rotate within the central ring1102.

Referring to FIGS. 28 and 29, the SI component 1100 includes a centralbore 1103 passing entirely through the central ring 1102 and arms 1106,1108 extending from the central ring 1102. The arms 1106, 1108 extend ina wing-like manner from the central ring 1102 curvedly tapering from aproximal end 111 toward a distal end 1112. Instead of rings extendingfrom the arms as in the previous embodiment, the arms include openings1114 that may extend entirely through the arm to receive screws 1300(not shown) in substantially the same manner as previously described inthe previous embodiment. The arms 1106, 1108 may include tracks 1116 forreceiving an augment (as depicted in FIGS. 34-38). The tracks 1116 maybe dovetail shaped and may be on either side of the arms 1106, 1108, onone arm or both arms. The tracks 1116 may run partially or entirely fromthe proximal end 1110 to the distal end 1112. The SI component 1100,from a profile view, may be U-shaped.

Referring to FIGS. 30-32, the AP component 1200 includes the tubularboss 1202 and a body 1204, with a central hole 1206 passing entirelythrough the center of the body 1204 and through the tubular boss 1202.The tubular boss 1202 may extend from the center of the body 1204 at adistal end 1218 of the AP component 1200. The AP component 1200 alsoincludes AP arms 1208, 1210 extending similarly to the arms of the SIcomponent 1100. The AP arms 1208, 12010 extend from the center of thebody 1204 at the distal end 1218 toward a proximal end 1216 in awing-like manner, curvedly tapering from the proximal end 1216 towardthe distal end 1218. The arms include holes 1214 that may extendentirely through the arm to receive screws 1300 in substantially thesame manner as the previously embodiment.

The AP component 1200 further includes a polygon recess or polygon key1220 toward the proximal end 1216 within the body 1204 of the APcomponent 1200. The polygon recess 1220 provides complimentary fit forthe polygon component 1060 wherein the polygon component 1060 may, butis not required to, sit flush with the proximal end 1216 within thepolygon recess 1220. Within the central hole 1206 is an engagement ring1222 that is substantially similar to the previous embodiment andinteracts in substantially the same way to form a snap fit or seal orother similar locking mechanism including a Morse taper (not shown)which may not require an engagement ring.

Referring to FIG. 33, an alternate embodiment a cylindrical component1400 with features of the AP component 1200 is shown, and is similar tothe cylindrical component 600. The elements of the body of the APcomponent 1400 are substantially similar to component 600, having atubular boss (not shown but within the central bore of the SI component1100), a central hole 1402 and a polygon recess 1404. The cylindricalcomponent may also include an engagement ring as previously described tolock the articulating component 1020 to the AP component 1400. Thisembodiment lacks arms and may be better suited to receive augments likethose depicted in FIGS. 34-38.

Referring to FIGS. 34-36, an augment 1500 is shown with the SI component1100 and the AP component 1200. The augment 1500 includes a straightedge 1502 with two dovetailed protrusions 1504 spaced apart from oneanother, perpendicular to the straight edge 1502, and configured toslide in the tracks 1116 of the SI component 1100. The straight edge1502 terminates on each end of the augment where two curved edges 1506arch back toward a midline of the augment 1500. A valley 1508 may dividethe augment into two minor image sides wherein each side of the augmentincludes a pocket 1510 which may receive a partial augment from thearticulating component 1020 similar to the partial augment ofarticulating component 420 or the one-piece augment articulatingcomponents 720, 760. The pockets 1510 may include holes 1512 passingthrough the augment 1500 to allow for passage of screws 1300 to securethe augment 1500 to the bone.

Referring to FIGS. 37 and 38, an augment 1600 may include substantiallythe same features of the augment 1500; however, the augment 1600 mayinclude tubular bosses 1602 extending in a direction away from thearticulating component essentially extending the length of holes 1604for receiving the screws 1300. The screws 1300 may secure the augment1600 to the bone.

Referring to FIGS. 39 and 40, an augment 1700 includes a curved surface1702 shaped to lie against a bone facing surface 1762 of an articulatingcomponent 1760. The curvature of the curved surface 1702 may match thecurvature of the bone facing surface 1762. Extending from the oppositeside of the curved surface 1702 of the augment 1700 is a saddle 1704that straddles a horizontal or AP component 2200. The augment 1700 mayinclude a centralized hole 1706 passing through the body of the augment1700 as well as additional holes 1708 passing through the body of theaugment 1700 to allow for passage of screws to secure the augment 1700to the bone.

Referring to FIGS. 40-43, an alternate embodiment of a glenoid vaultsystem 2000 is depicted with a vertical or SI member 2100, a horizontalor AP member 2200, screws 2300 and an articulating component 1750. Theaugment 1700 may or may not be present in this embodiment. This system2000 is similar to the previously disclosed systems 10, 1000 with theexception that a portion of the vertical member 2100 fits in thehorizontal member 2200 instead of vice versa. In this instance thehorizontal member 2200 is embedded into the bone and then a portion ofthe vertical member 2100 slides into a portion of the horizontal member2200.

The horizontal member 2200 includes all of the same elements aspreviously described for a previously described AP component 200 withthe exception that the features of the central rings 102, 1102 of theprevious embodiments are now found in the horizontal member 2200 insteadof the vertical member 2100. The horizontal member 2200 is embedded inthe bone in an anterior posterior direction first and then the verticalmember 2100 is embedded in the bone in a generally superior inferiordirection. The horizontal member 2200 includes a central ring 2202 thatis large enough to receive a tubular boss 2102 extending from thevertical member 2100.

Referring to FIG. 44, the horizontal member 2200 includes the centralring 2202 that defines a central bore 2204 that may pass partially orentirely through the central ring 2202. A screw 1300 may pass throughthe central bore 2204 to aid in securing the horizontal member 2200 tobone. Arms 2206, 2208 extend from the central ring 2202 rather abruptlyin a proximal direction terminating at a proximal end 2210. The arms2206, 2208 may be somewhat longer from the proximal end to a distal end2212 than previous embodiments of the SI components 100, 1100. The arms2206, 2208 may each include a bore 2214 which extend the entire lengthof the arm from the proximal end 2210 to the distal end 2212 and areconfigured to receive screws 1300. The bores 2214 may surround a largerportion of the screws 1300 because of the greater length of the arms2206, 2208 in a proximal/distal direction. Toward the distal end 2212 ofthe arms 2206, 2208 a portion of the arms 2208, 2008 on the lateral sidemay be cut away to expose the threads of the screw 1300 to allow forgreater security and fixation of the screws 1300 to the bone. Manyfeatures of the horizontal member 2200 are similar to those of thepreviously disclosed SI components 100, 1100 including the curvature ofthe arms toward the central ring 2204 matching the curvature of thecentral ring 2204 to allow the vertical member 2100 to rotate.

Referring to FIG. 45, the vertical member 2100 is short, narrow andelongated. The vertical member 2100 is stout from a proximal end 2104 toa distal end 2106. The tubular boss 2102 extends from the distal end andincludes a portion of a central hole 2108 that may extend entirely fromthe proximal end 2104 to the distal end 2106 and through the entirelength of the tubular boss 2102. The vertical member 2100 is elongatedbecause of vertical member arms 2110, 2112 extending outwardly inopposite directions from the central hole 2108. The vertical member arms2110, 2112 each include a hole 2114 to receive screws to secure thevertical member 2100 to the bone. The holes 2114 are separate from thecentral hole 2108. The walls within the central hole 2108 toward theproximal end 2104 may include grooves or notches 2116 that may form akeyed fit or complimentary interaction with articulating componentnotches 1764 seen in FIG. 40. These notches or grooves 2116 allowrotational orientation of the articulating component and preventrotation of the articulating member 1760 after it engages the verticalmember 2100. These notches or grooves 2166 may be rounded or squared orany shape that may prevent rotation and have the complimentary fit onthe articulating component 1760.

The vertical member 2100 may also include an engagement ring (not shown)that is similar to the previous embodiment engagement ring 222. Theengagement ring provides a reversible locking of the articulatingcomponent 1760 to the vertical member 2100 through a snap fit or seal,or other locking means including a Morse taper (not shown) which may notrequire an engagement ring, in substantially the same manner aspreviously disclosed.

The method for inserting the vertical and horizontal members into thebone is substantially similar as previously described except with thebone may require anterior-posterior preparation first instead ofsuperior-inferior preparation. The order of implantation and interactionbetween the components can be changed and is not meant to berestrictive.

Referring to FIGS. 46-51, an alternate embodiment of a glenoid vaultsystem 3000 with a horizontal member 3200 and vertical member 3100 isdepicted. The system 3000 is substantially similar to the previoussystem 2000 with a few notable exceptions. Horizontal member tracks 3202are in place of the bores 2214 in the arms 2206, 2208 of the horizontalmember 2200. Likewise vertical member tracks 3102 are in place of theholes 2114 of the arms 2110, 2112 of the vertical member 2100. Thetracks 3102, 3202 may be dovetailed to receive anchors 3300, which maybe blade anchors similar to those found in U.S. published patentapplication no. 2010/0204739, which is herein incorporated by reference,and are further depicted in FIG. 50. Another type of anchor is thatdepicted in FIG. 51 and which provides an alternate embodiment of theanchor 3300. The anchor 3300 may be a bone-augmenting anchor 3302 thatmay provide for alternate fixation by adding greater size to the bladeportion 3304. The blade portion 3304 of the bone-augmenting anchor maybe rectangular or trapezoidal in cross sectional shape. The bladeanchors 3300 may be embedded or inserted into the bone in the manner asdescribed in the incorporated patent application.

The method for implantation using blade anchors 3300 may be slightlydifferent simply because the blade anchors may require little to no bonepreparation for securing those anchors to the bone and is outlined inthe published patent application referenced herein.

Referring to FIGS. 46 and 49, the vertical member 3100 also includes newfeatures such as roughened or interrupted surface geometry that may becircumferential ridges 3104 that may aid in preventing pull out of thevertical member 3000. Ridges 3104 may be used in all the previousembodiments as well. The vertical member 3100 also includes a wall 3106cylindrically surrounding a central hole 3108. The wall 3106 includes toat least two cutouts 3110 on opposing sides of the wall 3106 toward aproximal end. The cutouts 3110 provide a keyed or complimentary fit withan articulating component (not shown) to allow rotational orientation ofthe articulating component and prevent rotation of the articulatingcomponent after engaging the vertical member 3100. The shape, size andnumber of the cutouts may vary and may be similar to those previousdescribed as notches or grooves herein.

Referring to FIGS. 52 and 53, a single anchoring system 3400 includesonly a vertical member 3402 that is implantable in a shoulder insuperior-inferior direction. The vertical member includes featuressubstantially similar to the previous embodiment vertical member 3100;however the present embodiment does not interact with a horizontalmember. This vertical member 3402 includes a distal end 3404, a proximalend 3406, and a central hole 3408 defined by a cylindrical wall 3410substantially the same as the previous embodiment vertical member 3100with the same cutouts 3110 as previously described. The central hole3408 terminates just prior to a distal end 3404 and does not passthrough the entire body of the vertical member 3402. Arms 3412, 3414extend from the cylindrical wall 3406 in opposite directions away fromthe central hole 3408. The arms 3410, 3412 terminate with blade anchors3300 integrally formed with the body of the vertical member 3400.

One or more tracks 3416 may be integrally formed within the body of thevertical member 3402 and extend from the proximal end 3406 toward thedistal end 3404 terminating just prior to the distal end. The tracks3416 may be dovetailed and are configured to receive anchors 3300. Thenumber of tracks 3416 may vary and may extend from only one side of thearms 3412, 3414 or both sides. An articulating member may interact andengage the vertical member 3402 in much the same manner as any of theprevious embodiment herein described.

Referring to FIGS. 54-56, an alternate embodiment of a glenoid vaultsystem 4000 is depicted. The system 4000 includes a vault 4100 that maybe pear-shaped, but may also be ovoid, spherical, cylindrical or manyother shapes. The shape of the vault 4100 may depend on the bonepreparation and the patient anatomy. The system also includes anarticulating component 4200, a screw 4300, which may be a scapular spinescrew, blade anchors 4400 as previously described herein, and a lockingnut 4500.

The vault 4100 may comprise a circumferential wall 4102 defining theshape of the vault and encircling a central hole 4104 and anarticulating void 4106 adjacent to and proximal the central hole 4104.The central hole 4104 may be cylindrical and may threadably or slidablyreceive the screw 4300. A screw seat 4105 (refer to FIG. 56) sits towarda distal end of the central hole 4104 and engages a head of the screw4302 and allows the screw 4300 to pivot to secure the vault 4100 to thebest bone. The locking nut 4500 is threaded and short and threadablyengages the central hole 4104 locking the screw 4300 in place andpreventing back-out. The locking nut 4500 fits at least partially, ifnot entirely, within the central hole 4104.

The articulating void 4106 provides a space for the articulating member4200 to engage and lock to the vault 4100. The articulating void 4106defined by the wall 4102 may have the same shape as the vault 4100. Thevoid 4106 may taper, providing an overhang 4108 of the wall 4102 toprovide a snap fit for engaging the articulating component 4200. Thewall 4102 may also include an engagement ring similar to thoseembodiments previously described that protrudes toward the central hole4104 into the void 4106.

Multiple tracks 4110 may be embedded in the outside of the wall 4102.The tracks may be substantially similar as the tracks 3416, 3102previously described herein and interact with the blade anchors 4400 insubstantially the same manner as previously described herein.

Referring to FIG. 57, the articulating component 4200 may be similar tothose embodiments previously described with the exception of the post. Apost 4202 extends from the bone facing side of the articulatingcomponent 4200 but may form a larger footprint from those postspreviously disclosed. The post 4202 may include a first lockingmechanism 4204 and a second locking mechanism 4206. The first lockingmechanism 4204 is a reverse taper that extends out from where the postinitially protrudes from the bone facing side of the articulatingcomponent 4200. On the opposite side of the post 4202 is the secondlocking mechanism 4206 that comprises a shoulder 4208 to snap into thevoid 4106 below the overhang 4108 of the wall 4102.

Referring to FIG. 58, the articulating glenosphere 4600 shows a similarengagement feature as the articulating component 4200 and engages thevault 4100 in substantially the same manner as the articulatingcomponent 4200. The articulating component 4200 and glenosphere 4600 arereversibly locked to the vault so revision surgeries are easilyaccomplished without having to remove the vault 4100.

One method for implanting the vault system 4000 is to prepare the bonefor the vault 4100 and securing the vault to the bone with the screw4300. After securing the vault 4300 the locking nut 4500 locks the screwinto place. The blade anchors 4400 may insert into the bone before,during or after the screw 4300 is inserted or fixed. The articulatingcomponent 4200 or glenosphere 4600 is then locked to the vault. Theorder in which the different components are secured is meant to beillustrative and not restrictive and the order may change within thescope of the system 4000.

In all embodiments described within this specification it will beappreciated that any articulating component or glenosphere will interactwith the vaults in such a manner to allow for easy attachment whilemaintaining a robust design. The engagement allows forinterchangeability from an articulating component to a glenosphere foreasy revision. The engagement described previously with a snap fit orseal, or other locking means including a Morse taper (not shown) whichmay not require an engagement ring, of either the articulating componentpost or the glenosphere post engaging the appropriate AP/horizontal orSI/vertical component with the groove and or ring.

The features of all of the different systems may include the following:the vertical member width may be less than 6 mm; the horizontal memberwidth may be less than or equal to 5 mm; overall vault depth may be lessthan 20 mm; the central portion or central ring diameter may be lessthan 9 mm; the central hole or central bore may be used for a scapularspine screw; and the cross members/components length or anchor sizingcan be varied.

The present embodiments may be embodied in other specific forms withoutdeparting from its spirit or essential characteristics. It isappreciated that various features of the above described examples andembodiments may be mixed and matched to form a variety of othercombinations and alternatives. It is also appreciated that this systemshould not be limited simply to shoulder replacement, revision or repairand may easily be adapted to other joint replacement technology,including, but not limited to hip repair. As such, the describedembodiments are to be considered in all respects only as illustrativeand not restrictive. The scope of the invention is, therefore, indicatedby the appended claims rather than by the foregoing description. Allchanges which come within the meaning and range of equivalency of theclaims are to be embraced within their scope.

1. A joint prosthesis system, comprising: a vertical component, whereinthe vertical component comprises a body comprising a first bore, whereinthe first bore extends at least partially through the body, wherein thevertical component comprises a first vertical component arm, wherein thefirst vertical component arm is integral to the body and extends fromthe body; a horizontal component, wherein the horizontal componentcomprises a wall defining an aperture, a protruded portion distal to thewall, wherein the aperture comprises a central axis and at leastpartially extends into the protruded portion, wherein the verticalcomponent engages the horizontal component; at least one anchor; and anarticulating component, wherein the articulating component comprises anarticulating surface, a second surface opposite the articulatingsurface, and a post, wherein the post extends from the second surface,wherein the articulating component engages the horizontal component,wherein the aperture of the horizontal component is shaped to receive aportion of the post.
 2. The system of claim 1, wherein the articulatingsurface has concave curvature.
 3. The system of claim 1, wherein thearticulating component comprises a side, wherein the side portionextends between the articulating surface and the second surface.
 4. Thesystem of claim 1, wherein when the vertical component engages thehorizontal component, the first bore of the vertical component is shapedto receive a portion of the protruded portion of the horizontalcomponent.
 5. The system of claim 1, wherein the anchors are at leastpartially contained within the first vertical component arm.
 6. Thesystem of claim 3, wherein the post comprises a shoulder portion,wherein the shoulder portion comprises a plurality of teeth.
 7. Thesystem of claim 6, wherein the post comprises a circumferential groove,wherein the shoulder portion is located between the circumferentialgroove and the second surface.
 8. The system of claim 7, wherein thewall of the horizontal component comprises a plurality of notches,wherein the notches are shaped to receive the teeth, such that when thearticulating component engages the horizontal component, the teeth arelockably engaged within the notches, wherein when the teeth are lockablyengaged within the notches, rotation of the articulating componentaround the central axis of the aperture is restricted.
 9. The system ofclaim 8, wherein the wall of the horizontal component comprises anengagement ring, wherein the engagement ring is distal to the pluralityof notches, wherein the engagement ring is proximal to the protrudedportion, wherein the engagement ring is shaped to be received within thecircumferential groove on the post, such that when the articulatingcomponent is engaged with the horizontal component, the engagement ringis at least partially contained within the circumferential groove, andproximal and distal movement of the articulating component relative tothe horizontal component is restricted.
 10. A joint prosthesis system,comprising a vertical component, wherein the vertical componentcomprises a body comprising a first bore, wherein the first bore extendsat least partially through the body, wherein the vertical componentcomprises a first vertical component arm, wherein the first verticalcomponent arm is integral to the body and extends from the body; ahorizontal component, wherein the horizontal component comprises a walldefining an aperture, and a protruded portion, wherein the aperture atleast partially extends into the protruded portion and comprises acentral axis, wherein the vertical component engages the horizontalcomponent, wherein the first bore of the vertical component is shaped toreceive a portion of the protruded portion of the horizontal component;and a glenosphere, wherein the glenosphere comprises a body and ametaglene, wherein the body comprises an articulating surface and adistal surface, wherein the distal surface comprises a recessed portion,wherein the metaglene is shaped to be received in the recessed portion,wherein the metaglene comprises a post and a first hole, wherein theglenosphere engages the horizontal component, wherein the aperture ofthe horizontal component is shaped to receive a portion of the post. 11.The system of claim 10, wherein the horizontal component comprises afirst horizontal component arm, wherein the first horizontal componentarm is integral to the wall and extends from the wall.
 12. The system ofclaim 10, wherein the articulating surface is dome-shaped.
 13. Thesystem of claim 10, wherein the recessed portion is offset from acentral axis of the glenosphere.
 14. The system of claim 10, wherein thepost comprises a shoulder portion, wherein the shoulder portioncomprises a plurality of teeth.
 15. The system of claim 14, wherein thepost comprises a circumferential groove, wherein the shoulder portion islocated between the circumferential groove and the distal surface. 16.The system of claim 15, wherein the wall of the horizontal componentcomprises a plurality of notches, wherein the notches are shaped toreceive the teeth, such that when the glenosphere engages the horizontalcomponent, the teeth are lockably engaged within the notches, whereinwhen the teeth are lockably engaged within the notches, rotation of theglenosphere component around the central axis of the aperture isrestricted.
 17. The system of claim 16, wherein the wall of thehorizontal component comprises an engagement ring, wherein theengagement ring is distal to the plurality of notches, wherein theengagement ring is proximal to the protruded portion, wherein theengagement ring is shaped to be received within the circumferentialgroove on the post, such that when the glenosphere is engaged with thehorizontal component, the engagement ring is at least partiallycontained within the circumferential groove, and proximal and distalmovement of the glenosphere relative to the horizontal component isrestricted.
 18. A joint prosthesis system, comprising: an articulatingcomponent, wherein the articulating component comprises an articulatingsurface and a second surface opposite the articulating surface, whereinthe second surface comprises a post and an augment, wherein the secondsurface comprises a first surface area, wherein the post is integral toand extends from the second surface, wherein the augment is integral toand extends from the second surface separate from the post, a verticalcomponent, wherein the vertical component comprises a body comprising afirst bore, wherein the first bore extends at least partially throughthe body, wherein the vertical component comprises a first verticalcomponent arm, wherein the first vertical component arm is integral tothe body and extends from the body; a horizontal component, wherein thehorizontal component comprises a wall defining an aperture, a protrudedportion, wherein the aperture at least partially extends into theprotruded portion and comprises a central axis; wherein the horizontalcomponent engages the vertical component, wherein the first bore of thevertical component is shaped to receive a portion of the protrudedportion of the horizontal component; and wherein the articulatingcomponent engages the horizontal component, wherein the aperture of thehorizontal component is shaped to receive a portion of the post.
 19. Thesystem of claim 18, wherein the articulating component comprises a sideportion, wherein the side portion extends between the articulatingsurface and the second surface.
 20. The system of claim 18, wherein thepost extends a first distance from the second surface in a substantiallycentral location.
 21. The system of claim 20, wherein the augmentcomprises a raised surface portion, wherein the raised surface portionis located a second distance from the second surface, wherein the seconddistance is less than the first distance.
 22. The system of claim 21,wherein the raised surface portion comprises a second surface area,wherein the second surface area is less than the first surface area ofthe second surface of the articulating component.
 23. The system ofclaim 18, wherein the horizontal component comprises a first horizontalcomponent arm, wherein the first horizontal component arm is integral tothe wall, wherein the first horizontal component arm comprises arecessed portion to receive the augment on the second surface of thearticulating component.
 24. The system of claim 23, wherein the recessedportion on the horizontal component is complementary to the raisedportion, such that when the recessed portion is engaged with the raisedportion, the raised portion is at least partially contained within therecessed portion, wherein rotation of the articulating componentrelative to the horizontal component is restricted.
 25. The system ofclaim 20, wherein the post comprises a shoulder portion, wherein theshoulder portion comprises a plurality of teeth.
 26. The system of claim25, wherein the post comprises a circumferential groove, wherein theshoulder portion is located between the circumferential groove and thesecond surface.
 27. The system of claim 26, wherein the wall of thehorizontal component comprises a plurality of notches, wherein thenotches are shaped to receive the teeth, such that when the articulatingcomponent engages the horizontal component, the teeth are lockablyengaged within the notches.
 28. The system of claim 27, wherein the wallof the horizontal component comprises an engagement ring, wherein theengagement ring is distal to the plurality of notches, wherein theengagement ring is proximal to the protruded portion, wherein theengagement ring is shaped to be received within the circumferentialgroove on the post, such that when the articulating component is engagedwith the horizontal component, the engagement ring is at least partiallycontained within the circumferential groove, and proximal and distalmovement of the articulating component relative to the horizontalcomponent is restricted.
 29. A joint prosthesis, comprising: aglenosphere, wherein the glenosphere comprises a body and a metaglene,wherein the body comprises an articulating surface and a distal surface,wherein the distal surface comprises a recessed portion shaped toreceive the metaglene, wherein the metaglene comprises a first surface,a second surface and a first hole, wherein the second surface isopposite the first surface, wherein the second surface comprises a post.30. The system of claim 29, wherein the recessed portion is offset froma central axis of the glenosphere.
 31. The prosthesis of claim 29,wherein the articulating surface is substantially dome-shaped, whereinthe articulating surface comprises an apex.
 32. The prosthesis of claim31, wherein the articulating surface comprises an aperture, wherein theaperture is at the apex of the dome.
 33. The prosthesis of claim 32,wherein at least a portion of the aperture comprises threads.
 34. Theprosthesis of claim 29, wherein the distal surface is substantiallycircular, comprising a circumferential boundary.
 35. The prosthesis ofclaim 34, wherein the distal surface intersects the articulating surfaceat all points along its circumferential boundary.
 36. The system ofclaim 29, wherein the metaglene is substantially disc-shaped, whereinthe metaglene is shaped to be lockably received within the recessedportion of the distal surface.
 37. A method for inserting a prosthesisinto a shoulder for shoulder repair, comprising: preparing a bone forreceiving an anchor; positioning a superior-inferior component into thebone, the superior-inferior component comprises a body comprising afirst bore, wherein the first bore comprises a seat, wherein the seat isshaped to receive the head of a screw, wherein the superior-inferiorcomponent comprises at least one superior-inferior component arm,wherein the first vertical component arm is integral to the body andextends from the body; positioning an anterior-posterior component atleast partially within the first bore of the superior-inferiorcomponent, the anterior-posterior component comprising a wall, whereinthe wall defines an aperture, wherein the anterior-posterior componentcomprises a protruded portion distal to the wall, wherein the apertureextends into the protruded portion; rotating the anterior-posteriorcomponent about the first bore to facilitate engagement with favorablebone; and engaging a glenoid component within the aperture, wherein theglenoid component comprises a body, wherein the body comprises anarticulating surface and a second surface opposite the articulatingsurface, wherein the second surface comprises a post that extends fromthe second surface, wherein when the glenoid component engages withinthe aperture, at least a portion of the post is contained within theaperture.
 38. The method of claim 37, wherein the at least one firstsuperior-inferior component arm comprises two superior-inferiorcomponent arms, wherein each of the superior-inferior component armsfurther comprises a lateral bore separate from the central bore, whereinthe method further comprises passing screws though each lateral bore;and securing the screws to the bone.
 39. The method of claim 37, whereinthe anterior-posterior component further comprises at least oneanterior-posterior component arm integral to the wall, wherein the atleast one anterior-posterior component arm comprises a lateral holeseparate from the central hole, wherein the method further comprisespassing at least one screw through the at least one lateral hole; andsecuring the at least one screw to the bone.
 40. The method of claim 37,wherein when the anterior-posterior component is engaged with thesuperior-inferior component, the first bore is aligned with the firstaperture, and the protruded portion is entirely contained within thebore, wherein the method further comprises inserting a screw through thealigned first bore and first aperture such that a head of the screw iscaptured by the seat; and securing the screw to the bone.
 41. The methodof claim 40, further comprising attaching the articulating component tothe anterior-posterior component by slidably locking the post within theaperture such that the head of the screw is lockably pressed against theseat.
 42. A method for inserting a prosthesis into a shoulder forshoulder repair, comprising: preparing a bone for receiving an anchor;positioning a superior-inferior component into the bone, thesuperior-inferior component comprises a body comprising a first bore,wherein the superior-inferior component comprises a firstsuperior-inferior component arm, wherein the first vertical componentarm is integral to the body and extends from the body; positioning ananterior-posterior component at least partially within the first bore ofthe superior-inferior component, the anterior-posterior componentcomprising a wall, wherein the wall defines an aperture; rotating theanterior-posterior component about the first bore to facilitateengagement with favorable bone; and engaging a glenosphere componentwithin the aperture, wherein the glenosphere comprises a body and ametaglene component, wherein the metaglene component is received by arecessed portion on the body, wherein the metaglene comprises a post,wherein when the glenosphere component is engaged with the aperture, atleast a portion of the post is contained within the aperture.
 43. Themethod of claim 42, wherein the at least one first superior-inferiorcomponent arm comprises two superior-inferior component arms, whereineach of the superior-inferior component arms further comprises a lateralbore separate from the central bore, wherein the method furthercomprises passing screws though each lateral bore; and securing thescrews to the bone.
 44. The method of claim 43, wherein theanterior-posterior component further comprises at least oneanterior-posterior component arm integral to the wall, wherein the atleast one anterior-posterior component arm comprises a lateral holeseparate from the central hole, wherein the method further comprisespassing at least one screw through the at least one lateral hole; andsecuring the at least one screw to the bone.
 45. The method of claim 44,wherein when the anterior-posterior component is engaged with thesuperior-inferior component, the first bore is aligned with the firstaperture, and the protruded portion is entirely contained within thebore, wherein the method further comprises inserting a screw through thealigned first bore and first aperture such that a head of the screw iscaptured by the seat; and securing the screw to the bone.
 46. The methodof claim 45, further comprising attaching the glenosphere component tothe anterior-posterior component by slidably locking the post within theaperture such that the head of the screw is lockably pressed against theseat.
 47. A method for replacing a glenoid that is engaged with avertical component in the bone with a glenopshere, comprising: removinga glenoid that is engaged with an aperture in a vertical component thatis inserted into bone; preparing a glenosphere, wherein the glenospherecomprises a body, wherein the body comprises a proximal hole, wherein atleast a portion of the proximal hole is threaded, and a metaglenecomponent, wherein the metaglene component is received by a recessedportion on the body, wherein the metaglene comprises a post; whereinpreparing a glenosphere comprises inserting the metaglene into therecessed portion; engaging the post of the metaglene in the aperture ofthe vertical component, wherein engaging the post in the aperturecomprises at least partially inserting the post into the aperture; andengaging a driving tool into the proximal hole and actuating the toolsuch that the glenosphere is pushed further into the aperture in thevertical component, wherein when the glenosphere is pushed further intothe aperture, the glenosphere becomes lockably connected to the verticalcomponent.